GPs are being pressured to reduce the number of patients they refer to
hospital in order to save money, a survey has suggested.

Research byGP magazinehas found that more than half of GPs had experienced 'inappropriate demands' from local NHS managers to send fewer patients to hospital.

The NHS is struggling to save £20bn in order to cope with rising demand for healthcare with more modest increases in budgets than in previous years.

The doctors described the ‘constant pressure to justify referrals and admissions, and pressure to avoid them’.

Under the efficiency drive doctors have been asked to review how many patients they refer and investigate how many of their patients attend A&E departments.

In 2008 several primary care trusts were found to be paying GP surgeries for reducing the number of patients they referred to hospital with £59 per patient paid in some areas and up to £15,000 per surgery in another.

It was later scrapped on government orders after fears were raised that it was 'unethical and dangerous'.

The new poll of 667 GPs also found only one in seven family doctors thought the measures have benefited patients.

One GP said the scheme had become a 'huge waste of time that could be better spent treating patients rather than meaningless government box-ticking'.

The 'quality and productivity' indicators are part of the payment by results portion of GP practice income.

Dr Richard Vautrey, deputy chairman of the GPs' committee at the British Medical Association, said: "We know that there is variation in the way PCTs and clinical commissioning groups (CCGs) have approached the 'quality and productivity' Quality and Outcomes Framework indicators, but the guidance is clear that practices must be involved in developing and agreeing the pathways to be used.

"If practices have concerns about how this is being done in their area they should make sure the local medical committee is involved in agreeing the pathways."

A Department of Health spokesman said: "‘These quality indicators are not about putting pressure on practices but ensuring they are doing the work reviewing admissions and referrals that they signed up to as part of the GP contract."